In-hospital cardiac arrest (IHCA) is a common event that is associated with poor patient outcomes. Yet, some hospitals have been consistently more successful in preventing and treating IHCA than others. While this is thought to be explained by the adoption of key strategies that improve care processes for IHCA, how these strategies are actually utilized in routine practice and the underlying factors contributing to their successful implementation remain largely unknown. Further, an integrative approach that examines strategies used during IHCA and those employed before and after these events has not been previously undertaken. This study will build on extensive prior work by our investigative team using the American Heart Association's Get With The Guidelines (GWTG)- Resuscitation registry and leverage our team's expertise in IHCA and qualitative research. The proposed HEROICA study will lay the foundation for future quality improvement efforts in IHCA by defining 'best practices'adopted by top-performing hospitals to address these events as well as potential barriers to their implementation. We will use a sequential mixed-methods approach to accomplish this goal, integrating quantitative and qualitative analyses. Its 3 Aims will: (1) identfy top- performing hospitals in preventing and treating IHCA within the GWTG-Resuscitation registry;(2) identify 'best practices'at the top-performing sites through semi-structured qualitative interviews;and (3) validate the practices associated with low IHCA incidence and high IHCA survival at top-performing sites. Findings from the study will be used to construct a toolkit of 'best practices'- the Code Blue Bundle. Upon successful completion of this research, we will partner closely with the American Heart Association (AHA) and the GWTG-Resuscitation registry to develop a national quality improvement program that will implement the Code Blue Bundle. Thus, the HEROICA study will increase the capacity of the NHLBI to improve outcomes for patients who suffer an IHCA by providing hospitals with practical and actionable strategies that can be implemented broadly to reduce the incidence and improve the survival of IHCA.
As cardiac arrests occur frequently in U.S. hospitals, this study will enable us to understand why some hospitals are much better at preventing and treating this condition than the rest of the nation. By identifying the strategies used by these to-performing hospitals, our hope is to be able to share these 'best practices'with all hospitals so that fewer patients experience and die of cardiac arrests in the hospital setting.
|Chan, Paul S; Berg, Robert A; Tang, Yuanyuan et al. (2016) Association Between Therapeutic Hypothermia and Survival After In-Hospital Cardiac Arrest. JAMA 316:1375-1382|
|Chan, Paul S (2016) Letter by Chan Regarding Article, ""The Utility of Therapeutic Hypothermia for Post-Cardiac Arrest Syndrome Patients With an Initial Nonshockable Rhythm"". Circulation 133:e611|
|Sinha, Shashank S; Sukul, Devraj; Lazarus, John J et al. (2016) Identifying Important Gaps in Randomized Controlled Trials of Adult Cardiac Arrest Treatments: A Systematic Review of the Published Literature. Circ Cardiovasc Qual Outcomes :|
|Girotra, Saket; van Diepen, Sean; Nallamothu, Brahmajee K et al. (2016) Regional Variation in Out-of-Hospital Cardiac Arrest Survival in the United States. Circulation 133:2159-68|
|Chan, Maya L; Spertus, John A; Tang, Fengming et al. (2016) Missed opportunities in use of medical emergency teams prior to in-hospital cardiac arrest. Am Heart J 177:87-95|
|Chan, Paul S; McNally, Bryan; Nallamothu, Brahmajee K et al. (2016) Long-Term Outcomes Among Elderly Survivors of Out-of-Hospital Cardiac Arrest. J Am Heart Assoc 5:e002924|
|Ranchord, Anil M; Spertus, John A; Buchanan, Donna M et al. (2016) Initiation of Î²-blocker therapy and depression after acute myocardial infarction. Am Heart J 174:37-42|
|Khera, Rohan; Chan, Paul S; Donnino, Michael et al. (2016) Hospital Variation in Time to Epinephrine for Nonshockable In-Hospital Cardiac Arrest. Circulation 134:2105-2114|
|Chan, Paul S; Krumholz, Harlan M; Spertus, John A et al. (2015) Effectiveness of implantable cardioverter-defibrillators in survivors of inhospital cardiac arrest. Am Heart J 169:870-878.e1|
|Virani, Salim S; Maddox, Thomas M; Chan, Paul S et al. (2015) Provider Type and Quality of Outpatient Cardiovascular Disease Care: Insights From the NCDR PINNACLE Registry. J Am Coll Cardiol 66:1803-12|
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